(a) For persons in long-term care, any income deductions, with the exception of other health insurance premiums under Sections 14005.4 and 14005.7, shall not be deducted in the post-eligibility treatment of income determination pursuant to Section 14051.7 to the extent allowable under federal law or regulations.

(b) Once the beneficiary has medical expenses that are not subject to payment by a third party and are equal to or exceed their long-term care patient liability amount, the individual is entitled to receive health care services pursuant to Section 14005 if all other applicable eligibility criteria established pursuant to this chapter are met. Those medical expenses may include, but are not limited to, any of the following:

Terms Used In California Welfare and Institutions Code 14005.95

  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC

(1) Medicare health insurance deductibles and coinsurance charges.

(2) Other health insurance deductibles and coinsurance charges.

(3) Necessary medical and remedial services.

(4) Expected expenses for inpatient long-term care in a medical facility.

(Added by Stats. 2023, Ch. 42, Sec. 86. (AB 118) Effective July 10, 2023.)